May 28, 2011 1:18 PM

Hi! I am a 19 year old college runner who (thankfully!) does not deal with injury that much. I have minor compartment syndrome in my legs, but I am able to manage it very well. This morning however, I woke up with a very strange feeling in the ball of my foot. It almost felt like I was stepping in something small, but there was nothing there! It did not hurt, even when I pressed on it or walked around. I later went for a run, and felt totally fine, didn't even notice it, even though I ran 6 miles at 7:10 pace, which is pretty quick for me at this stage in my training. It didn't hurt afterwards either. I iced it twice, and it feels as though maybe it's going away, but I am not sure. Has anyone ever felt this before? Thanks!

I've had something like that from time to time. I don't know what causes it. I thought it might be Morton's Neuroma, but it never really hurts. And it goes away for weeks or months at a time. Sorry I can't help you more than that.

A likely scenario for someone in the middle of their college running career is the kind of "mild" compartment syndrome that is brought on by excessive exercise, resulting in nerve pressure and associated various dysesthesias that can mask what is really going on. Chances are it has everything to do with the above and nothing to do with the ball of your foot per se, while several muscles and/or nerves in the lower leg that influence the ball of the foot are bound to be impacted by any measurable level of compartment syndrome. Pressure on the deep peroneal nerve, for example, can result in isolated symptoms pretty close to where you are talking about. Altered sensation in the first web space between the first two toes is not unheard of.

Was this condition (CS) diagnosed by needle insertion? Did your physicians/trainers mention the connection to overtraining, sudden increases in training level, and/or consistent training at too high a level? You stated being "pretty quick .. at this stage" in your training. Try to envision your condition if it progresses through your senior year. I am sure you have been made aware of the consequences of compartment syndrome on muscle health and what hangs in the balance. If these symptoms persist, or new problems like "drop foot" or noticeable changes in gait, footstrike, or hip flexion become evident, you are going to need to take a break to think this over. Potential death of muscle tissue for the glory of the team is not what you are training, or in school for.

If the condition was diagnosed by measuring pain on passive stretching of the first toe and/or weakness of active flexion, you can be thankful to have this early warning. Talk with your trainer to see if there are other workout plans involving less tempo mileage, maybe short repeat challenges with adequate recovery and easier long runs to keep your base. Hammering away for 45 minutes at a time might not be the best way to deal with your condtion, and imo is likely to make it worse. I say "condition" because someone told you what you "have," and likely where it could lead, regardless of whether it really bothers you a lot in the early stages, or even concerns you yet. Your posting in this forum is a good sign. Continue to inquire; CS is not to be taken lightly, much less by any athlete.

Meanwhile, look into talking with someone familiar with "myofascial release" techniques, which are a proprietary system of therapies designed to deal with fascial compartments and their associated restrictions and pathologies. Don't take this snapshot in time as a given, or as genetic destiny. There are ways of changing your luck. You are not alone, and there are plenty of other collegiate athletes in this make-or-break situation. I wish all schools had the same resources as professional athletes do. We know the money is always an issue with endurance sports, but the motivation can be weak with an endless supply of young athletes coming onto the field. Regardless, your health going forward is primarily your responsibility. Continue to think ahead. Best of luck to you, and thanks for joining a forum where other runners benefit from your experiences, good or bad.

One more thing: If you habitually cross your legs while sitting, stop!

My compartment syndrome was not diagnosed by needle insertion, just by a description of my symptoms and observation of my legs. It did flare up during this past fall, when I was probably overtraining, but since then i was very careful with my training and was doing low mileage, lots of cross training, and was running with zero pain. The weird thing about this foot issue is that currently, I am at the start of my summer training, so I am doing very low mileage, only running 5 days a week, easy runs (with the exception of the 6 mile run I described above). The weirdest part is that it started the day after an off day in which I basically sat on the couch all day! I did use a foam roller on my legs that day (which I use all the time to help with my compartment syndrome). Usually, this is very beneficial to me, but do you think it could have been a cause? I also went shoe shopping and tried on about 10 pairs of shoes that day (daytime does, not running shoes) so I don;t know if that could have been an issue. It's my third day with the feeling, and it hasn't changed at all (still no pain and it isn't any worse). Yesterday I ran an easy 3 miles on trails (felt fine) and today I'm taking off. Thank you everyone for your replies!

re: foam roller, yes, if there is any neuropatholgy associated with a likely case of early compartment syndrome, there could be some exacerbation due to relentless pressure on the affected nerves, be they cutaneous or even deep motor-related. While I am obviously a big fan of massage, my beef with foam rollers is that they are inherently unspecific in that they spread pressure out into unrelated areas. I prefer more focused work, some of which can be diagnostic when areas "light up" in response to specific pressure near a responsible nerve.

I am happy to hear you have adjusted your training load, since we too often hear otherwise in the med-tent forum. There are two things I would do at this point: (1) Because of what is at stake, revisit the diagnostic procedures that led to the earlier diagnosis, in a way that does not cause undue concern resulting in them benching you. Just make it clear that you want to be informed about the progress of a possible condition in order to optimize your training. The next thing I would do is (2) focus your self-directed remedial action to address exactly what they find, if anything. I worry about what athletes may do to themselves when left alone with a foam roller, some nagging pain, and unlimited time to make things worse. This is always a risk with self-directed therapies, although I am also a proponent of diy therapies of all kinds, to fill in the gaps not financially available to most non-professional athletes, and to improve outcome. The operative word is "improve.

Also, if you foam roll, you must take care to apply pressure on the proximal (toward the heart) stroke only, to avoid adversely affecting the semi-lunar valves in your lymphatic vessels and veins that are most common in your distal extremities. This is one of the dangers of diy therapies like rollers.

There are no doubt key portions of your fascia that can be expanded to accommodate muscular development as you continue to grow into your sport physically. Exppect a different kind of pain during this process. While I am on that subject, I am reminded of a few older posts about sensations in the ball of the foot that can be harbingers of bunions. I used to run regularly with a former collegiate runner who had developed a bunion in one of her feet and was pondering remedial surgery at the time. Another poster referred to developing bunions after 6 years of competitive running. It doesn't just happen overnight; there are signs. See if a sports podiatrist can evaluate you. Sometimes an MRI is the best way to detect this, though they are priced out of reality for most of us in this country. Check my post on bunions here:http://community.active.com/message/1002074#1002074

I look at areas of your leg that are served by different nerves, available via wikipedia: